A budget deal reached Tuesday does not include a controversial proposal to limit how much doctors can charge for dispensing drugs to workers' compensation patients.

Sen. Alan Hays, a Umatilla Republican who spearheaded the proposal, said it did not survive budget negotiations between the House and Senate. Former Gov. Charlie Crist also vetoed such limits last year.

The Florida Senate on Monday blew holes in a medical-malpractice bill backed by doctors and hospitals, as the House overwhelmingly approved the proposal across the Capitol.

Senators eliminated key parts of the bill, including one that would shield hospitals from liability if contracted physicians commit malpractice. Hospitals often contract with outside groups of physicians, such as radiologists, to provide care.

With hundreds of millions of dollars riding on their decisions, House and Senate negotiators remained sharply divided Wednesday about how to balance the health and human services budget.

The House and Senate exchanged proposals that included major differences on Medicaid payment rates for hospitals, nursing homes and physicians. Also, they split on issues such as the Medically Needy program, biomedical research and mental-health and substance-abuse treatment.

Inching toward agreement on a Medicaid overhaul, a Senate committee Wednesday eliminated a proposal that would have required HMOs to spend 90 percent of the money they receive on patient care.

Instead, the Senate Health and Human Services Appropriations Subcommittee approved a profit-sharing plan backed by the managed-care industry. Under that plan, the state would receive a cut if HMOs make Medicaid profits of more than 5 percent.

Under fire from lawmakers, the Florida Department of Health has proposed a sweeping plan to reorganize --- and shrink -- its operations. Among other things, it would move the state out of the primary-care business.

The recommendations, released in a 154-page report, call for cutting 1,608 department jobs and consolidating dozens of divisions and bureaus. One of the proposals would buck the powerful doctors' lobby by lifting a requirement that the department secretary be a physician.

House Health and Human Services Chairman Rob Schenck does not like Florida's prescription-drug database. That much is clear.

But after listening to more than two hours of testimony last week about the state's notorious pill mills, the Spring Hill Republican refused to say how he wants to combat prescription-drug abuse.